Hypoglycemia: That Dog-Gone Low Blood Sugar

This
column is going to be a little different, because instead of explaining something
about diabetes, I’m going to tell a story about some recent events in
my own life with diabetes.

I have had type 2 diabetes since 1991. I was already a diabetes educator when
I diagnosed my own diabetes, and soon told my doctor about it. Because I had
severe side effects with oral medications, I have used insulin from the first
year. After doing multiple injections for several years, I got an insulin pump,
and have managed my diabetes with a pump ever since then.

As a diabetes educator, I have seen all the major diabetes complications in
my patients, so I am highly motivated to prevent complications in myself. Therefore,
I have done intensive management from the beginning, trying to keep my blood
sugar as close to normal as possible. Of course, it’s nearly impossible
to do this perfectly. So at times, I have low blood sugar, or hypoglycemia.

On the day this story begins, I was lying on my bed. A little circular thought
was running around my brain, saying, “I don’t feel so good….
I wonder what’s happening to me…. I really don’t feel good….
I wonder what this is…. I don’t feel good…. I wonder…..”
Round and round this thought went, repeating itself over and over.

Suddenly, I felt a cold, wet nose and a fuzzy snout against my neck. My dog,
Yoda, was pushing against my neck. He is small – only about 11 pounds
– but he was pushing with all his might. Finally, it occurred to me that
he wanted me to get up. I stood up, still not feeling so good and wondering
what was happening to me. Yoda pushed against the back of my leg. A drop of
sweat dripped off the end of my nose. That drop of sweat broke through my circular
wondering with a fact: Sweat dripping off the end of my nose is one of my personal
signs of hypoglycemia. I realized I was having low blood sugar, so I went and
checked it. It was 57 – low enough that I needed to treat it, so I ate
four glucose tablets. Fifteen minutes later, my blood sugar was 72, so I knew
I had treated it enough. Later, I thought about what had happened, and I realized
that Yoda had been signaling me.

I had heard that dogs sometimes alert their owners to hypoglycemia, but never
expected that Yoda, at the age of eight years, would suddenly be one of them.
I wondered if he would do it again. To make a long story short, my old dog had
indeed learned a new trick. He has signaled me every time I have had hypoglycemia
in his presence for about the last year.

After my experience, I became very curious about dogs that alert their owners
to hypoglycemia, and searched the terms “diabetes alert dog” and
“diabetes service dog” on the Internet. I learned that there are
four schools in the U.S. that train dogs for this purpose. I also found several
newspaper and magazine stories about dogs that, like Yoda, spontaneously started
alerting their owners to hypoglycemia.

After reading about all of these dogs, I decided that it would be helpful if
I were certain that Yoda would always alert me, and to have him with me more
of the time. In order to do that, I needed him to learn better manners for being
in public. Although he was trained well enough to be a good pet, a service dog
must have a higher standard of good behavior. While the Americans with Disabilities
Act does guarantee that service dogs can accompany their humans in public, this
right applies only if the dog has excellent public behavior. A service dog owner
whose dog is out of control or threatening in public can be asked to remove
the dog.

I found a service dog trainer in my area, and Yoda and I met with her. I learned
more than I knew there was to know about dog training, and once I knew the training
techniques, Yoda learned very quickly. He now has a service dog vest, and he
knows that when he is wearing the vest he must be on his best behavior.

For most of the last year, Yoda has gone with me almost everywhere. He is quite
consistent about alerting me to hypoglycemia, often before I recognize that
I am feeling the symptoms. (I do always check my blood sugar when he alerts
me, just to be sure.) As a person with type 2 diabetes, I do not have hypoglycemia
as often or as severely as many people with type 1. But Yoda’s help has
improved my life. He lets me know when I have low blood sugar early in the process,
while it is dropping, but before it gets really low. By treating early, I can
avoid feeling awful for several hours afterwards.

So what would I say to someone who is thinking of getting a diabetes alert
dog? First of all, I believe that it’s important to work with a professional
service dog trainer. A diabetes alert dog needs to be consistent in detecting
low blood sugar, for obvious safety reasons. Furthermore, as explained above,
anyone who takes a dog out in public has a responsibility for that dog behaving
well.

Another consideration is that training for diabetes alert dogs is relatively
new. Most service dog trainers do not know the training techniques. Therefore,
I think a person who wants a diabetes alert dog should probably get one from
one of the schools.

Now, here I have to add a disclaimer: I do not have any personal experience
with any of the schools. I only know what I have read on their web sites. If
you want a diabetes alert dog, I would suggest that you contact all of them.
Some will only serve people from a particular part of the country. The amount
of time that you would spend with your dog in training, and the fee for a dog,
can be very different at different schools. I imagine that there might be differences
in their training procedures. You’ll have to find out as much as you can
from the schools, and then make the decision that you think is best for you.

Having said all that, I hope that if you decide to get a diabetes alert dog,
your experience is as good as mine has been. Please let me know! You can contact
me through the editor of the Voice of the Diabetic.

About
the AuthorAnn S. Williams is an RN, with a PhD in Psychology, and has worked
as a diabetes educator for 20 years. She has specialized in teaching independent
diabetes self-management for blind people and writes and speaks frequently on
this topic for other health care professionals. She was the founder and past
chair of the Disabilities Specialty Practice Group of the American Association
of Diabetes Educators, and remains an active member of that group.